| Brook Lane Health Services/laurel Hall | |
|
13310-a Brook Lane Hagerstown MD 21742-1514 | |
| (301) 733-0330 | |
| (301) 733-4038 |
| Full Name | Brook Lane Health Services/laurel Hall |
|---|---|
| Speciality | Counselor - School |
| Location | 13310-a Brook Lane, Hagerstown, Maryland |
| Authorized Official Name and Position | Kristy Poffenberger (COORDINATOR/MANAGED CARE) |
| Authorized Official Contact | 3017330331 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brook Lane Health Services/laurel Hall 13310-a Brook Lane Hagerstown MD 21742-1514 Ph: (301) 733-0330 | Brook Lane Health Services/laurel Hall 13310-a Brook Lane Hagerstown MD 21742-1514 Ph: (301) 733-0330 |
| NPI Number | 1891185658 |
|---|---|
| Provider Enumeration Date | 02/02/2015 |
| Last Update Date | 02/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891185658 | NPI | - | NPPES |
| 568605900 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YS0200X | Counselor - School | 3852 (Maryland) | Primary |
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